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a Old plain chest X-ray (two years before presentation), which was essentially normal. b Chest X-ray at presentation. Mediastinal shift towards the right hemithorax, a vague left cardiophrenic angle and a raised left hemidiaphragm clearly demonstrate herniation through the left hemidiaphragm. c CT scan of the upper abdomen. Large posterolateral diaphragmatic hernia containing distended stomach, occupying the whole left hemithorax.
